Fixing Botched Penile Thickening Procedures: Repair & Revision Options

Expert Penis Enlargement Repair & Revision Services

Complications after penile thickening procedures are more common than most men realize. At Rejuvall, we routinely treat patients who have experienced:

• Failed fat transfer
• Uneven or lumpy penile fillers
• Granulomas from PMMA or hyaluronic acid
• Dermal graft degradation
• Asymmetry after surgical girth enhancement
• Vanishing or migrated fillers
• Silicone-related complications (addressed separately)

Many of these patients were told their outcome was “normal” or “untreatable.” In reality, most complications are correctable when evaluated by a board-certified reconstructive urologist with penile-specific experience.

Lost Fat Graft Repair

Restoring Penile Girth After Fat Transfer Failure

One of the most common repair requests we receive involves partial or complete fat graft loss after penile fat transfer (FFT).

Common causes include:

• Inadequate donor fat quality or volume
• Smoking history
• Elevated A1C / metabolic disease
• Poor fat filtration or handling
• Improper injection depth

Repair Options at Rejuvall

Depending on the cause and remaining tissue:

• Sculpted PMMA placement around surviving graft
• Repeat FTT using FDA-approved filtration systems
• Hybrid correction for patients chasing post-operative “swelling size”

Each plan is individualized — fat loss is not a one-size-fits-all problem.

Uneven Penile Shaft Repair

Lumps, Asymmetry & Irregularities

Shaft unevenness is one of the most emotionally distressing complications after girth enhancement.

Uneven Penile Filler Correction

Why Cannula-Based Injections Fail

Most non-surgical girth irregularities stem from cannula-based injection techniques, which are poorly suited to penile anatomy.

Key problems with cannulas:

1. Reduced placement precision
2. Higher likelihood of granuloma formation
3. Filler migration and uneven distribution

Cannula-based injection techniques are frequently used by non-urologic providers and are commonly associated with the same complications seen after unsafe silicone and oil-based injections.

Only a board-certified urologist trained in penile anatomy can safely inject the shaft without a cannula. This is why many clinics rely on cannulas — not because they’re better, but because they’re easier.

Rejuvall uses non-cannula MacroSculpting™ techniques to correct these deformities safely.

Repair After Surgical Girth Enhancement

Fat Transfer Asymmetry

• Caused by regional fat necrosis
• Often corrected with sculpted PMMA layering

Silicone Implant Irregularities

• Common near the glans during erection
• High infection risk
• In many cases, non-intervention is safest

Dermal Graft Unevenness

• Often requires injectable correction
• Severe cases require surgical graft excision

Vanishing Hyaluronic Acid Fillers

When Penis Fillers “Disappear”

We increasingly see men who received large volumes of HA (10–18 mL) with no measurable girth increase.

Likely causes:

• Cannula placement allowing HA to drain into dependent tissues
• Poor injection plane selection

There is no medical harm from displaced HA — the body reabsorbs it — but it is an expensive failure.

Many providers take a weekend course, adopt branded marketing language, and begin offering penile injections without urologic training. Patients pay the price.

Penile Dermal Graft Repair

Degradation, Necrosis & Uneven Results

Dermal grafts (autologous, cadaveric, or synthetic) are still used internationally, but Rejuvall discontinued them due to:

• High degradation rates
• Limited achievable thickness
• Inability to layer grafts
• Significant hospitalization requirements

Repair Strategies

• Injectable correction for mild degradation
• Surgical excision for necrosis or instability
• Staged reconstruction when necessary

Fat Necrosis After Penile Fat Transfer

Hard Lumps & Oil Cysts

Fat necrosis occurs when transplanted fat cells die from oxygen deprivation.

Progression:

1. Fat cell death
2. Oil cyst formation
3. Calcification
4. Scar tissue development

Most cases resolve naturally. Persistent nodules may require:

• Needle aspiration
• Surgical excision

Men often confuse fat necrosis with filler-related lumps, which is why accurate diagnosis is critical. We cover this distinction further in our guide to bumps after girth enhancement.

Penile Filler Granuloma Removal

Nodules vs Immune Reactions

What Is a Granuloma?

A granuloma is a localized immune response to foreign material. It is not the same as a benign filler nodule.

For a deeper medical explanation of how penile filler granulomas form, how they differ from benign nodules, and why they are more common after improper injection techniques, see our detailed guide on penile filler granulomas vs nodules.

After Hyaluronic Acid (HA)

• Caused by foreign body giant cells (FBGCs)
• Risk increases with penile-level volumes (5–15 mL vs 1–2 mL facial use)
• Treated with hyaluronidase

After PMMA

• PMMA intentionally induces inflammation
• Granulomas may persist
• Adding more PMMA makes it worse
• Surgical removal may be required

Covering PMMA granulomas with additional PMMA is one of the most dangerous mistakes we see.

Many men with PMMA-related granulomas were originally told they were receiving a “safe” or “medical-grade” injectable, despite these terms often being used to obscure significant risks.

We explain this misleading marketing in detail in our medical review of pharmaceutical grade silicone penile injections.